GULU LA INSULIN

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Insulini ndi mahomoni a kapamba a munthu amene ntchito yake ndikuchepetsa ndikuwongolera kuchuluka kwa shuga m'magazi.

Matenda osiyanasiyana a metabolic amabweretsa kusalinganika kwamankhwala a insulin komanso kulephera kwa ntchito yake yachilengedwe. Poterepa, adotolo endocrinologist amatipatsa mankhwala omwe amapangitsa kuti pakhale kusowa kwa timadzi timeneti. Mitundu yonse ya insulini imagawika m'magulu molingana ndi chiyambi, nthawi yakutulutsa komanso nthawi yake.

Mwa chiyambi

Ma insulin onse amawagawa m'magulu anayi mwa mitundu yoyambira:

M'badwo woyamba insulin
Insulin yachiwiri
Insulin m'badwo wachitatu
Wachinayi m'badwo wa insulin

Chidule cha ng'ombe zamtunduwu za insulini zimayimira ng'ombe, chifukwa zimachokera kwa iwo (komanso kuchokera ku nkhumba) kuti mankhwalawo amapezeka.

Mankhwala amtunduwu, mosiyana ndi insulin yaumunthu, nthawi zambiri amakhumudwitsa mawonekedwe a matupi osagwirizana, chifukwa amakhala ndi 20% yokha yodetsedwa mwa mawonekedwe a somatostatin, proinsulin, glucagon ndi ma polypeptides ena.

Pali amino acid amodzi mu nkhumba insulin (monopic), koma izi sizititsimikizira kuti munthu sangachite nawo chifukwa chake.

Kuti mupeze mankhwalawa, pancreatic pork gland imagwiritsidwa ntchito, yomwe imakulolani kuti mukhale ndi 1.5% yokha yodetsa.

Uku ndikukonzekera kopitilira muyeso komwe kumatsukidwa 100%. Ndiwotetezeka kuposa zosankha zam'mbuyomu, chifukwa sizipangitsa kuti ma hypoglycemia aziwoneka bwino.

Izi ndi zosiyana mwanjira ya insulin yomwe imapanga insulin ndi mankhwala aanthu. Mitundu iyi ya insulin imapangidwa pogwiritsa ntchito njira zosiyanasiyana.

Insulin yaumunthu imapezeka ndi kaphatikizidwe ka Escherichia coli, ndipo insulin yopangidwa mwamaumbidwe imapezeka kuchokera kukonzekera kwa porcine, pokhapokha amino acid imalowedwa m'malo.

Gulu lomaliza la mankhwalawa limawonedwa ngati mankhwala oyenera kwambiri komanso ovomerezeka omwe amachititsa kuti thupi likhale ndi vuto losagwirizana ndi zovuta zina. Mu insulin yamtunduwu mulibe puloteni wakunja, ndiye woyenera kwambiri kwa anthu.

Kulembera kwa mankhwala osokoneza bongo

Mukamagula insulini polemba, mutha kudzipezera nokha kuti ndi gulu liti komanso momwe limayeretsedwera.

Chifukwa chake:

Ngati phukusi lidalembedwa MS, ndiye kuti mukugwira gawo limodzi lokonzekera (oyeretsedwa monocomponent).
Kulemba MN zikutanthauza kuti tsopano muli ndi analog ya insulin ya anthu m'manja mwanu.
Kuphatikiza pa kufotokozera, kukonzekera kotereku kumatha kulembedwa mwa kuchuluka. 40 kapena 100 phukusi limatanthawuza kuchuluka kwa magawo a mahomoni omwe amapezeka mu mankhwalawa pa 1 mg. 100 kapena zingapo zikutanthauza kuti mankhwalawo amakhala ndi kuchuluka kwa mahomoni, ndiye kuti ndi penphilic. Kuti mulandire chida chotere, ma syringe apadera amafunikira. Nthawi zambiri, mankhwalawa amagulitsidwa kale mu ma syringes amenewo.

Mafupikitsidwe oterewa ndi ofunikira kwambiri pakupezeka kwa insulin, chifukwa muyenera kugwiritsa ntchito mawonekedwe omwewo nthawi zonse.

Ndi nthawi yowonekera

Kutalika kwa mankhwalawa machitidwe azachipatala ndikofunikira kwambiri.

Chifukwa chake, insulin imagawidwa m'magulu otsatirawa mogwirizana ndi nthawi yomwe ikuchitikira:

Short Range (ICD)
Kuthamanga kwambiri
Kutalika kwapakati kuchitapo kanthu (ISPD)
Zinthu zokhala ndi nthawi yayitali (IDD)

Mukamwa mankhwala a gululi, imayamba ntchito yake mkati mwa ola limodzi, koma mphamvu yake yokwanira imatheka maola a 1-4 atatha kugwiritsa ntchito. Zimatha maola 5-6.

Ndikulimbikitsidwa kuyambitsa mtundu wa insulin musanadye kwa mphindi 15-20. Pambuyo poyambitsa, tikulimbikitsidwa kuti "kuluma" ndi china chake, mutha kugwiritsa ntchito zipatso kapena zakudya zina "zosalemera".

Amatchedwa "yosavuta" kapena mankhwala osokoneza bongo posachedwa. Zotsatira zake zimatheka pokhapokha pakukhazikitsidwa, kukwera kumachitika maola 1-1.5.

Kutalika kwa kuchitapo kumatenga maola 3-4. Gwiritsani ntchito mitundu iyi ya mankhwala makamaka mukamadya kapena musanadye.

Munthu amamva mphamvu ya mankhwalawa pambuyo pa mphindi 30-60, koma mphamvu yake itha kumveka pokhapokha maola 4-10.

Izi zimatenga pafupifupi maola 10 mpaka 20. Mwachizolowezi, munthu amafunika jakisoni awiri amtunduwu wa insulin chifukwa chakuti zotsatira zake sizimveka nthawi yomweyo.

Pambuyo kugwiritsa ntchito, munthu amayamba kumva kuyambika kwa mankhwalawa pambuyo pa maola 3-4, ndipo mphamvu yakeyo imatheka pokhapokha maola 8-18. Izi zimatha pafupifupi maola 24-28.

Insulin yamtunduwu imafuna kutenga nthawi 1-2. Mankhwalawa amayenera kumumwa pafupipafupi, chifukwa amagwira ntchito polimbitsa thupi.

Cholinga cha mankhwala ena a insulin zimatengera zinthu zambiri, zomwe zikufotokozedwa pansipa.

Kodi mungasankhe bwanji insulin?

Monga aliyense amadziwa kale, ndizosatheka kusankha mankhwala amodzi padziko lonse pochiza matenda enaake. Matenda aliwonse ndi amodzi, chimodzimodzi ndi kulekerera kwa mankhwala.

Kuti musankhe mtundu woyenera wa insulin kwa wodwala aliyense molondola, muyenera kuyang'ana zinthu izi:

Zokhudza thupi mtundu uliwonse wa mankhwala, monga, kuchuluka kwa mayamwidwe, kutalika kwa vutoli komanso kutheka kwa matupi awo sagwirizana.
Zizolowezi za aliyense payekha. Ayenera kuganiziridwadi, chifukwa amatha kusokoneza malingaliro a insulin ndi thupi (kuchuluka kwa mowa, chizolowezi chosuta, chizolowezi cha zinthu zina, ndi zina).
Chiwerengero cha jakisoni. Popeza anthu ena sangathe kubayira insulin panthawi inayake, dokotala amatha kusankha mankhwala omwe, mwachitsanzo, muyenera kugwiritsa ntchito nthawi 1 kapena 2, osati 3.
Nthawi zambiri anthu amafunika insulin pomwe kuchuluka kwawo kwa shuga kumapitilira magawo abwinobwino, chifukwa chake ayenera kumayeza nthawi ndi nthawi. Chiwerengero cha miyeso zimakhudzanso kusankha kwa mankhwala.
M'badwo wodwala. Pazaka zilizonse, dokotala amatha kusankha mankhwala pawokha.
Zizindikiro zaumwini chifukwa cha shuga.

Pazifukwa zambiri, mtundu uliwonse wa insulini umalembedwa zotere. Mankhwala aliwonse omwe amaperekedwa ndi matenda a shuga a ketoacidosis, hyperosmolar coma kapena matenda ashuga a ketoacidotic.

Mankhwala wamba

ICD yodziwika bwino ili ndi dzina:

insuman mwachangu,
mangochita
Actrapid NM
Actrapid MS,
humulin pafupipafupi
Iletin wokhazikika, etc.

Yang'anani! Ndi zoletsedwa kugwiritsa ntchito waukulu Mlingo wa ICD. Kuti muthane ndi vutoli, muzigwiritsa ntchito mankhwalawa.

Insulin Yotalika Pakatikati ali ndi chidule ISPD. Amawerengera matenda omwewo monga momwe tafotokozera pamwambapa. Izi zikugwiranso ntchito kwa mitundu ina ya mankhwala. Mankhwala ofala kwambiri a ISPD amatchedwa:

insuman basal,
protafan, etc.

Yang'anani! Insulin yamtunduwu imatha kusakanikirana, koma pokhapokha ngati pali mankhwala osakhalitsa ofanana mulingo wina uliwonse. Ndikofunika kuti mankhwala owonjezera omwe amasakanikirana ndi ISPD apangidwe pamaziko a proteni Hagedorn (I-NPH) osaloledwa. Musamale mukasakanikirana ndi insulin yamtunduwu ndi mankhwala omwe atenga nthawi yayitali, chifukwa izi sizingachitike.

Mankhwala odziwika kwambiri a IDD khalani ndi dzina:

humulin ultralente,
Glargin
ultratard nm.

Yang'anani! Kukonzekera kwa insulin kwakanthawi kochepa kumatha kusakanikirana ndi mankhwala osachedwa (osavuta). Zosakaniza zoterezi pafupifupi m'malo onse ogulitsa mankhwala amagulitsidwa okonzeka. Ziwerengero zake zimatha kukhala zosiyana kwambiri (10:90; 20: 80 ... 50:50). Izi zimapangitsa kukhala kosavuta kwa anthu achikulire omwe ali ndi vuto lowona kuti amwe mankhwalawo ndikulowetsa muyezo momwe angathere. Zovuta zotere zimayamba kugwira ntchito posachedwa ndipo zotsatira zake zimakhala nthawi yayitali.

Chabwino, zomwe zimagulidwa nthawi zambiri insulin yapamwamba khalani ndi mayina:

Humalog,
Apidra
Novologist.

Njira zokhala ndi kuchuluka kwa insulin

Izi zimatheka ngati mugwiritsa ntchito pampu. Ndi mtundu wa zida zomwe zimapereka mankhwala mosalekeza kulowa mthupi la munthu. Madokotala ena adatcha chida ichi "pancreas yokumba."

Mfundo ya pampu ndikupereka insulin, yomwe ili ndi mitundu iwiri:

Zoyambira (kumbuyo) machitidwe. Zimafunikira kuti m'malo mwatsopano insulin. Pa 1 koloko pampu imayambitsa payokha mankhwala ena.
Bolus regimen imadziwika ndi kamodzi kayendetsedwe ka zinthu pokhapokha ngati chakudya (wodwalayo akadya chakudya china). Njirayi ikufanana kwambiri ndi jakisoni imodzi ndi syringe.

Mapampu onse amasiyana mwachangu pakubereka kwa insulin. Mapampu amakampani osiyanasiyana amatha kuperekera mankhwalawa pama liwiro osiyanasiyana (kuchokera pa 0,01 mpaka 0,05 u / h). Ndikofunikira kuti aliyense payekha asankhe pampu pamilandu iliyonse.

Ndikotheka kusungitsa kuchuluka kwa insulin kokha osati mothandizidwa ndi pampu - syringes ndi cholembera syringe zimathandiza anthu ambiri. Ubwino wawo pamapampu ndiye mtengo. Wodwalayo amalowetsa insulin m'mitsempha ndi syringe, kenako ndikuponya. Ma syringe amasinthanso.

Zotsatira zoyipa

Zotsatira zoyipa kwambiri komanso zofala kwambiri mwa anthu omwe akumwa insulin ndi lipodystrophy. Ichi ndi matenda a minyewa pomwe wodwala amapanga jakisoni. Pali nthawi zina pamene kumwa insulin mwa wodwala kumayambitsa hypoglycemia, yomwe iyenera kuthetsedwa mwachangu ndi chokoleti kapena kapu ya madzi. Zotsatira zoyipa izi zimachitika ndikumwa insulini yoyenera (mwa njira yoyeretsedwa kwambiri). Ngati munthu amwa mankhwala a insulin pang'ono, ayenera kukhala okonzekera mawonekedwe a thupi lawo.

Insulin ndi chinthu chofunikira kwambiri chofunikira pamoyo wa munthu. Ndipo thupi likalephera kudzipangitsa lokha, munthu amafunikira chida chake chopanga. Iyi ndi mfundo yofunika kwambiri, chifukwa munthu aliyense amafunikira insulini yake. Kukaonana ndi dokotala pankhaniyi kumangoyenera, mwinanso mungayike khungu lanu pachiwopsezo.

Kwa odwala matenda ashuga, zonsezi ndizofunikira kwambiri, chifukwa kudziwa za kugwiritsa ntchito mankhwalawa moyenera, kumene adachokera, njira zothandizira kuti shuga azikhala ndi nthawi yayitali komanso kuyamwa azithandiza anthu ambiri kusankha insulin yawo.

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